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Home My WebLink About2-40-08� �,'' � " I"`" ` °: Y��,.; ,_ ��;. �'�.:»�. � = � _._ �.�_,._.__�:x .� _..�� _, -�,. __ . "' . � � � . . � Certificate No. 2331 �� 0 �'� �� Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Wilma White &/or Kimberly Waltermire 5690 N. Tropicana Drive Sebastian, FL 32958 In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 2, Block 40, Lots 8& 8a of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 10t" day of April, 2012. CITY OF SEBASTIAN, FLORIDA '��AI Minner City Manager ATf E ST : � � ..,'°r f � ': - _.., ' �.-_._. � Sally A. aio, MMC City Clerk cnl' � °��L �� ;— �`�,,�� :��- FI41YtE L3F �PE�;ICAN !�[.At�1D City of Sebastian Niunicipal Cemetery Purchase Receipt �� ,v\ � �'� � To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. , � L�F��f�- r:�l,i i(�rn G� Ck v� c�/� � � i av� b�_ Y' �-- �r.� a t�"� �( nn `t Ir � C� �� ll �fe,t-� Name(s) ' `�JCoQ1� IJ, r-oPtCC�n� �ri �/�� 10RS-i��C�v1 �Z�S� - Address , . ��Z � cJ��1 -��i�(; Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: ��tl`a �i��.,�4�t./.1C� �`�' ' �� ----�-� --J Dollars (� �.C�Ob, o� � on this. /��'' day of �Tp�' c( , 20� for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit _�, Block � Q , Lot(s) �� Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. Additional Fees paid at time of purchase: Corner Markers (set of 4-$20) Opening & Closing Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation _ , � � Signature of Purchaser Interment /W O H Circle One Disinterment Tc�� G�U vo ��m� ity of Sebastian The following documents were provided as Proof of Residency: i:IM�V-�ATA\.nqs-Gemetery\RFCFIPT-�or I i �a CITY OF SEBASTIAN CITY CLERK'S OFFICE - 4 4 5 b RECEIPT Name �b �j :�� ( Cash Date �� d�� Z ❑ Check # No. 001001 208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifying Fees Amount Paid 601010 343800 Cemetery Lots �„(1[�� LoUNiche O �' �a, Block �_, Unit �_ 001501 343805 Cemetery Fees w�-��Q�-�Q� Total Paid , �(�(j.C7D Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant .�. . , ., , ..-.,_ ..r �. . � :;£,. . .. . >: �... ., .. . LOT AVAILAB LE FOR SALE UNIT BLOCK �D , �, ______ •`y LOT � � � -a �-y0 �-- g �, � � � ��. �.Q �� c� . � �o� �wv I _ GY`�. 1 [ ,� .� : � ��ao�� Uc.� a -� o � c��. C� � � � � �� , C�-> VY10 � � � . � �...s� S M � G U � ��O � � �� I A..� � wc�-Q 'Y��1� � � c��",-��?�Q � 0 � � � �� v ` � � V v � � p , � -�c��- �`� �� W�-�:� , � � ` c� S �.— � ° � � �. � � � 0 G� � �- �c� � � �� , � � ,� '�eF °�`—� � �v �� ` `� �. � � ��: �L, i ' f r"� � j� �'f° j 4 z� !` "r\ � a ..—} ''�") e L„) i .r:,, ,�{j� � � ` �'� L . � ' 1!,,.'�� 1 1.:� . � �=`�� t�.. C> ll.,� � Name �C..'�.� � . �._, � ! ��Unit Block �� L�t � - tC�� 4��-r �v,��-��) � _ -�2��.��1. �ate �f Mark �u �� .; � �� 1� S` 4",�''-- ��`��`� Ti m e �� Date of Burial Name of Funeral Home �� -? � � � ; ,/" r t � s �,,.,... y�Cr l. �Ll�i CJC.., �� 1j "" �� L.'�"�! .}�' . Authorized by � ---- � . _ ------_ ___ _----- _ _ �'TY°F 071278 CITY OF SEBASTIAN � WACHOVItI CHECK NO. 1225 MAIN STREET 712 7 8 SEBASTIAN, FL 32958 . �� '' � . "� GENERAL ACCOUNT .. � -.,,�� HOME OF PELICAN ISLAND VENDOR CHECK DATE 10074 05/08/200 *********61 DOLLARS AND 40 CENTS 63-643 670 CHECKAMOUNT $61.4 PAY patricia Jacobi L ID IF`NOT PAID WITHIN 90 DAYS 127 Curtiss Parkway #34 iii TO THE Miami Springs FL 33165 /� -_ I/�� 1. ._.__ .'�J . 1 . . _ ORDER --_ __._.______ -.._... __-_-._.__ _ __ TWO SIGNATURES REQUIRED ��'07i2`�8�i' �:06 70064 3 2�:20000273L6296ii■ 71278 CITY OF SEBASTIAN SEBASTIAN, FL 32958 INVOICE DATE INVOICE NUMBER INVOICE DESCRIPTION 05/06/09 RUFUND-Cemet Lots 8& 8A-Unit 2 blk 40 100745 Patricia Jacobi LACP4GL 050809 NET INVOICE AMOUNT PO NO. 61.40 61.40 nr ror i�71278 69905 71278 Ac,� ocs�\ �� '�-��•�4�''� � CITY OF SEBASTlAN! i I CHECK REQUES � { � Accourrting Use (?nty � �Input Date Fiscaf Period � Document # Entered By Document Amount # of Lines Totai HC Hash # To Be Compieted By Department �Due Date �/8/2009 Single Check Y/ N Y Vendor Number � � Document Organization Object Project LN TC Reference Code Code Code Amount 601011 534959 $61.40 �,mount $61.40 Description Refund minus fiees for lots in Unit 2, Bik 40, Lots 8& 8A (deed has been surrendered} �_ �SSUE CHECK TO � NAME Patricia Jacobi ADDRESS 127 Gurtiss Parkway #34 e Miami Springs, FL 33166 ` ,� APPROVED BY �� !�, � � � �` DATE ,�. .,�r l� j � BUDGET APPROVAL (53400d D 535450 ONLYj � � i ' � i ._, _�R� .- _.,_. � f _ . ,.. . , . --�-- , . _ . .;;_-� ..� __ ,_. .. —� .,.. . . . . ,.,...,.. .._.. . . : . .. .aeAr SEBASTIAN MAIN POST OFFICE SEBASTIAN, Florida 329589998 1169180454 -0096 05/05/2009 (772)589-4397 03:34:49 PM - Sales Receipt Product Sale Unit Final Description Qty Price Price CONYERS GA 30094 Zone-4 $18.90 Pri ori ty Mai 1 13 lb. 13.2 oz. Return Rcpt (Green Card} $2.20 "'"' Regi stered $10.00 Insured Value : $0.00 • Article Velue : $0.00 Label #: RE134440432US Customer Postage -$31.10 Subtotal: $0.00 sss'ms:s= Issue PVI: $0.00 Total: $0.00 Paid by: "" Save this receipt as evidence of insurence. For information resardin5 domestic insurance, visit our website at usps.com/insurance/postoffice.htm Order stamps at USPS.com/shop or call 1-800-Stamp24. Go to USPS.com/clicknship to print shipping labels with postage. For other information call 1-800-ASK-USPS. Bill�t: 1000402801715 Clerk: 05 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business **************************************** ***«*«********************************** HELP US SERUE YOU BETTER Go to: http://9x.gallup.com/pos TELL US ABOUT YOUR RECENT POSTAL El(PERIENCE YOUR OPINION COUNTS ********************«*********«,�*******« **************************************** Customer Copy — Registered No. �f34440432US Date Stamp Reg.Fee ;ld.�� 4�J� Handling • Return • a5 9 Charge Receipt d � Postage . Restricted • ��'�� a p Delivery o� mao Received by �^�^+.,� Domestic Insurance up to T $25,000 is included in the fee. h m Wlth Postai � Intemational Indemnity Customer Must D a� � �nsurance is IimRed. Full Value $, � yy�thout Postal (�e Reverse). d a d f � ; o 0 c LL U.-a T � q mam dms dWd adm E a w Uv� d Q m d � � W a PS Form ., May 2004 For d� Insurance �� e��`��: �� =�� C��f Sebasti.an 1225 Ma.in Street Sebasti.an, FL 32958 Mr. Joe Whi c/o Manastery of Holy Spi�rit 2625 Hi.ghway 212 SW Conyers, GA 30094-404/+ Receipt for Registered Mail Copy 1- Customer 0-02-000-905i) (See Information on Reverse) J tic delivery information, visit our website at www.usps.com � � � C� o � �� .�� —�j . / 0 C� _ � o , c� o s� ��o �� .- �7 , 5 � �i�--5� �- � � � v , � � � �f o r�. � � ��5� ( � � aC � s f � �-e. � Q��n -�� o sfia� � ��- � � ��I t �tf� A� �p�t�I��t�ri (��e�t�e��e�� ed N� . z5s THIS INDENTURE MAD� Thia ..... 9tI1.... ... daq of ... AU9USt ................................. A. D., 197�..., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, ns Grantor and Robert L. and Ruth E. Jacobi ....................................................................................................................................... .............. P.,.�,.. Box, 353i..Roseland...................................................................................... of the County or . . . . . . Indian. .Riyer, , , , , , , , , , , , , , , , , , , , , an.3 State of . . . . . Florida .. ............................................. as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $**.�.?�*.Q�.** . ................ to it in hand paid, the receipt whereof is herewith acknowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee. .�.h6,�T. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: Block 40, Unit #2 . . iill . . .of Lot S . 6d�8A. . . . . . . . . . in Section . . . . . . . . . . . . . of Sebastian municipal cemetery as per Plat Number 1 there- of recorded in Plat Book 2, at page 68 of the public records in the office of the Clerk of the Circuit C'ourt of St. Lucie County of Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, heretofore, now and hereafter adopted or provided for the government and operation of said ceme- tery. The conditions, restrictions and requirements contained in this instrument shall be covenants runtl�ng with the land. In the event of the failure of the owner of any property situated within said cemetery to observe and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shali revert to the City of Sebastian, Floridu. IN WITNESS WHEREOF, T�ea�d party of the first part has caused this instrument to be executed in its name and on its be- half by its Mayor and attested by its City Clerk and its corporate seal to be heteto affixed, the day and year first above written. �7 ` � . �tteSt: ...�:� ......... .. .. ........................ A88t City rk Si ned, Sealed and Delivered i the Presence of: �' 1 . ��l.�t�-.o....�........L�'L:.i:`:"`.'.�:.�: v� ............ , ...........................� ..... .... . �� CITY OF SEBA6TIAN, FLORIDA � B] ....._..Y... . . ... . ...... .. . . .. a or (f�'rkg �ett1) STATE OF FLORIDA COUNTY OF INDIAN RIVER � / �. I HEREBY CERTIFY, That on this . . . .��` . . . . . . . . . . . . . day ot . . . . . . . . . . �. . . . . . . y . . . . . ., 19 7 ., F: Eu ene Cra tlsie m. Cam bell before me personally a$�P �d ........... �.......... �9 ................................. and .....................P................. respectively Mayor and'�y C'lerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuals and officers described in and who executed the foregoing conveyance to ...................R.ctb.e�.�. �,..a�d.RUth. E....J.a�ob.1.......................................................................... ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said canveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year last aforesaid. ' � . . . . . . . . . . . . . . . . . . . . . . .f,!t!. . � . . �/7<C` •_'•' •�—�' Notary Public, State of Florida at Large. My Commission explres: Florida at Large NotarY Public, State of arch 1, 1976 Mv Gommission Expires M �onded by Aetna Insurance ��^�'�anY �� i� � HOME QF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM U -�z �-�Io �.- � I, Patty Jacobi, on behalf of Robert & Ruth Jacobi (deceased), Grantee(s) of City of Sebastian Cemetery Deed # 258, do hereby transfer my/our interest in the following: Lot(s) 8& 8A, Block 40, Unit 2 of the Sebastian Municipal Cemetery to: The City of Sebastian 1225 Main Street, Sebastian, FL 32958 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their intermenf sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation. " P/ease check one: � I hereby certify that I am selling back to the City of Sebastian my interest in the above referenced site(s) and will be reimbursed the purchase price at time of purchase, minus 5% administrative cost set out in R-08-27 and any other mailing costs. (P/ease provide the origina/ deed when returning this form) I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of�ebastian. /��,. 6A ) //�a , .7'"�(� �i� � `^; a�� Signature of Original �fa�tee State of �,�� County of ��_ + e#ore�me; this � day of " ,� personally appeared :� ' known to m r who produced as identification, who acknowledged to me that he/she/they sa f r the uses and purposes herein set forth. -vyp ,�''"""�, ANGELA C. WILLIAMS otary b ic i nature Printed Name: �sv con�n��s�� ? 9 My Commission Expires: a F� ��_� �� Notary Stamp: �.�;":: s •, ..� , ,�.W � The CiW of �stian hereby consents to the transfer of burial rights• / w ` ATTEST: ' City Manager Sally A. Maio, MC - City Clerk Appr as to Form and egal Sufficiency: � obert A. Ginsburg, City Attorn y \WAS\CityCIe�ClAppl\Word Data\W W-DATAUASCemetery\Transfer of IMerest Fortn.tloc ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Mr. Jce Whittaker Haney Creek Woodlands c/o Manastery of the Holy Spirit 2625 Highway 212 SW Canyers, GA 30094-404�+ A. Si i X ❑ Ad� B. eiv by (Prin d e) C. t D. Is delivery address different from item 1? Ya If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certifled Matl ❑ Express Mail b`] Registered ❑ Return Receipt for Merohandise ❑ Insured Mail ❑ C.O.D. 4. Rest�icted Deliveryl (Extra Fee) ❑ Yes 2. Artic�e Number R E 13 4 4 4 0 4 3 2 U S (Tiansfer from servke /abel) PS Form 3811, February 2004 Domestic Retum Receipt 102595-02-M-1540 �� y�� HOME OF PEUCAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM I, Patty Jacobi, on behalf of Robert & Ruth Jacobi (deceased), Grantee(s) of City of Sebastian Cemetery Deed # 258, do hereby transfer my/our interest in the following: Lot(s) 8& 8A, Block 40, Unit 2 of the Sebastian Municipal Cemetery to: The City of Sebastian 1225 Main Street, Sebastian, FL 32958 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow intermenis in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation. " P/ease check one: � 1 hereby certify that I am selling back to the City of Sebastian my interest in the above referenced site(s) and will be reimbursed the purchase price at time of purchase, minus 5% administrative cost set out in R-08-27 and any other mailing costs. (Please provide the original deed when returning this form) I hereby certify that I have received no remuneration for this transfer. 1 request the consent of the City of,Sebastian. ---' �r r`�; ; ��'� � � � • f� i� �' - Signature of Original Grantee State of —S��`°`�"'``� County of �C , Be�ore-rrre; anr this ,� day of ,�� personally appeared r��('lP.� �� G�,:�f�C , known to m� r who produced as identification, who acknowledged to me that he/she/they sa f r the uses and purposes herein set forth. � _ . , � -,yp �'`""'� ANGELA C. WILLIAMS otary b ic i nature Printed Name: MY coMM�ss��j � Zo 2 9 My Commission Expires: a r� v� �� Notary Stamp: '�", ° "'"`�"�' By: n hereby consents to the transfer of burial rights: AI Minner, City Manager Approved as to Form and Legal Sufficiency: Robert A. Ginsburg, City Attorney 1WAS\CRyCIeACWpq\WOM Dala\WW-DATAUAsCemeteMTransferof Interest Porm.doc ATTEST: Sally A. Maio, MMC - City Clerk ;� � � 5/�r . -� an� SE��V HOME OF PELICAN ISLAND SEBASTI�N MUNICIPAL CEMETERY 1921 N. Central Avenue, Sebastian, FL 32958 •(772) 589-2545 ■ Fax (772) 228-9927 April 29, 2009 Patty Jacobi � 127 Curtiss Parkway #34 � Miami Springs, FL 33166 Dear Ms. Jacobi: The Sexton gave me a copy of your letter to him requesting the disinterment of your parents from the Sebastian Cemetery. To begin this process please mail the original deed to me along with the attached form filled out and notarized. I want to reiterate that the amount you will be receiving back will be the purchase price of $150.00 minus the administrative fee ($7.50) and shipping costs (to be determined). Please do not hesitate to call me if you should have any questions. Sincerely, ,./ �j � ' o/ �`_.......-�- Sally . Maio, MMC Ci lerk Attachment �� s��v d� HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENTFORM I, Patty Jacobi, on behalf of Robert & Ruth Jacobi (deceased), Grantee(s) of City of Sebastian Cemetery Deed # 258, do hereby transfer my/our interest in the following: Lot(s) 8& 8A, Block 40, Unit 2 of the Sebastian Municipal Cemetery to: � [� The City of Sebastian 1225 Main Street, Sebastian, FL 32958 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation. " Please check one: I hereby certify that I am selling back to the City of Sebastian my interest in the above referenced site(s) and will be reimbursed the purchase price at time of purchase, minus 5% administrative cost set out in R-08-27 and any other mailing costs. (Please provide the original deed when returning this form) I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of Sebastian. Signature of Original Grantee State of _ County of Before me, on this day of , , personally appeared known to me or who produced as identification, who acknowledged to me that he/she/they executed the same for the uses and purposes herein set forth. Notary Public Signature Printed Name: My Commission Expires: Notary Stamp: The City of Sebastian hereby consents to the transfer of burial rights: By: ATTEST: AI Minner, City Manager Sally A. Maio, MMC - City Clerk Approved as to Form and Legal Sufficiency: Robert A. Ginsburg, City Attorney IWAS\C0yC1eAcWppl\WOrtl Data�WW-0ATA\MsCemetery\Transfer of Interesl Fortn.tloc April 21, 2009 Sebastian Municipal Cemetery 1225 Main Street Sebastian, Florida 32958 Attn: Mr. Kip Kelso Dear Kip, Thank you for taking the time to explain the procedures to remove & ship my parent's remains from the Sebastian Municipal Cemetery to Honey Creek Woodlands Burial Grounds, in Conyers, Georgia. Please let me know the cost to remove my parent's remains & ship them to the following address: Honey Creek Woodlands 2625 Highway 212 SW Conyers, Georgia 30094 Attention: Joe Whittaker I am enclosing a copy of the cemetery deed, as per your instructions. It is my intention to sell the burial plot back to the City of Sebastian. Please deduct the cost to remove, & ship my parent's remains from the sale of the plot back to the City of Sebastian, & send me a check for the balance. I would appreciate it if you could store my Father's head stone, until I can make arrangements to retrieve it. I do not want my Mother's head stone. Please let me know when this can be arranged, & I will mail the original cemetery plot deed to your attention. Please let me know if you require any additional information to make the arrangements. Sincerely, �� .�- � Patty co 127 Curtiss arkway #34 Miami Springs, FL 33166 (pejacobi@yahoo.com) t�d� l�} t3 t... tZ� FF� �� U't !� Ti i;; i � r � � �y `�� -::,� � �C_ ° ; �� . � � . �� ii� c �� rr� m .., �� : ; � � -� :�", � � � � � \ _ Y � �I � �� \ � V � �u-� �, � . �� . a Z � � � - � � � �� ...� � 0 - - 0 - O O �� W � -J � ..0 � � �� ln �� "�� ,: ��: . \�, . . �, ~�� . �.� � �� b �, �. �ro � � � r� � �,, ... W � � � � D * O pN N O C y � � N �� =� N =� �O i�� W �� —�,� �� 3 c °�. �t 3: o/ A 3 WS+�:n N~ , CN��i•D-� / _ • ?' 00 N^��`� oN�� , V � D W m � t� _---�i � 3 �,� � � ; � i � � ' � � , i , , � s�� - � ;� � � � � �� . i i 6 � � � ' �` � y '` �`= -� � � � J �•f ' ' M1� ,� �.��.. ;� , . � -�`\ ��,�+ �� \ � -'' � , �� i � �o � � � � �� I � � . 1 � r I . ' ,'; T .. . � � . v ♦ f � h � ',� . . � . J 0 Name Unit_ Block Lot _ 7; Date of Mark-out f v "' ,�+' ,ts � � Date of Burial ��.��A ' Time � � ' � Name of Funeral Home e �''�� "`° Authorized by � �' JACOBI, Robert & Ruth P. O. Box 353 (Manatee Ave.) Roseland, F1a. 32957 0 Deed #258 Unit #2, BZock 40, Lots 8, gg ;y, _ ��. , ,..Gi��C� Ge2/ - -/� - � ` ,. �� ii' /� � ) � / � �> . _,�_�- -� �: � � ;.�y,� Paid by General Receipt No. . . .` . '. . . . . . . . . . . . Dated . ?.� ''. . . : : . : . % ' .,. . . �. !? . . %' `° % � : � l� '� . , ,""" ;"'r__ =.�-, List Yrice $.... ...... . 3laximum No. �'Qrial spaces ............ ___-----°-"`_, �, �. Discount $. ...'".... .. Total area in sqnare feet_ . . .:�': _ . . . .... . ; ' < --- � I�'et Paid $.... .:�.�........ Monument petmitted .....��.%`-':�..... � -�.�.,..t�-ol. R....�c. ��. '��%/� Q, �� 7� (Data above Yhis line for City R.ecord only) �"� s /� •'�,` ,�--'y" - _ °. y��--�•,.;-� .�-- ''�r- ��.,.�..�� ;�_ - _.. . ��, .? � � � ��'�-`-`� '-"-'_� �•�,E`:`r-�.��.c. ��..�=.�`<- : --� ; ; '-- ''� � ---< �� _.�� ':,l�� u� -�:�� !'�, �' ,d_. ��,��'✓ �� °`� CE hA Index:RECORD # Last Name Address i Address 2 �lt�! Deed # Unit # Lot Number Lot Number Lot Number Lot Number Comment Comment <F>wrd City of Sebastia�n,. FL - Cemetery Lats JACOBI First Name ROBERT & RUTH P.O.BOX 353 MANATEE AVE. ROSELpND State FL Zip 258 Date 08-09-74 Amount $150 2- Block # 4� 8 Int�rred Ruth Jacobi tcremains} $ Interred Robt. Jacobi Uet.Ccremains) $A Interred Patricia Interred Pd. 15.00 far her! Rabert & Ruth will be interred in lat $ cord:656 32957- Dte Interred 09-1�-01 Dte Interred Dte Interred Dte Interred lot 8A is reserued far daughter Patricia Jacobi, fram Miami k CE}dit CD7elete <H}ext {P>re+� <R}e-search CL>abel <T>a�t <Esc> Thursday, Mar 03, 2005 12:58 PM